The Pink Salt Trick for Weight Loss is a Scam Work of Art

I regularly keep tabs on a few Youtube channels and have become fascinated by some of the scammy ads that I am forced to watch. I've become particularly enamored by ads for the "pink salt trick" for losing weight. The people featured in the ads (probably partially AI creations) go on, and on, and on, about how a few simple ingredients can cause massive weight loss, without diet, exercise, or using weight loss drugs. Somehow they never get around to explaining what those simple ingredients are.

If you search Youtube for the pink salt trick, you will get lots of videos from supposedly different people telling the same basic story. It's funny to see different women repeating the exact same talking points about their alleged experience. Claiming that they had to eat more burgers just to stop from wasting away is a nice touch. I was particularly amused by the claim that the pink salt trick is more effective than Zepbound and Mounjaro combined, since those two are actually the exact same drug under different names. I assume that the dialogue is carefully crafted to stay just within the bounds of the law (or perhaps Youtube's advertising standards), thus the mispronunciation of drug names or references to "those Lilly pills" (Lilly doesn't have weight loss drugs in pill form yet). If you take a step back, these videos are a masterclass in manipulating human psychology.

Curiosity finally got the better of me and I clicked one of the provided links. I was taken to a website that claimed that the new recipe was causing celebrities to lose 14 pounds in 10 days...which is not at all a healthy rate of loss. I don't know if it's even possible to lose that amount of fat that quickly. In addition to a video, the webpage had the words, "Scientific References" above logos for leading news sources (NY Times, CBS, ABC, FOX, CNN). None of these had any clickable links. Below that was a number of testimonials allegedly from Facebook. At the bottom was a disclaimer that began with this sentence: "He [sic] result of this content may vary from person to person, depending on each organism." LOL.

The video player wouldn't allow me to go forward or back so I sat through the whole thing, which lasted probably 45 minutes. The video started off a lot like the ads on Youtube, but it eventually transitioned to (supposedly, more later) The Oprah Podcast with Oprah talking with actual endocrinologist Dr. Ania Jastreboff. Oprah and Dr. Ania talked through Dr. Ania's discovery of the pink salt trick and it's miraculous effects, and how it mimics the weight loss drugs. Obviously, the pharmaceutical companies are furious about this and have threatened to ruin Dr. Ania's career. There was a subtle transition that was interesting to watch. Initially the pink salt trick was so simple that anyone could do it in a few seconds. Much later in the video, Dr. Ania stated the 4 ingredients: pink (Himalayan) salt, green tea extract, berberine, and resveratrol. A little while later she said that the recipe requires ingredients of a purity that can only be obtained from a Chinese supplier, and that it has to be formulated in an precise way.

At last, Oprah revealed that the product you need is LipoVive, and from there the video followed typical infomercial techniques. Although you can order it in packs of 1, 3, or 6, viewers were encouraged to order the 6 pack for several reasons. First, it brings the price per bottle down from $89 to $49. (Incredible savings!) Second, if you bought the 6 pack you would be entered into a drawing for a chance to hang out with Oprah on an all-expenses paid vacation to Greece. Additional incentives included books on how to lose weight easily, which seemed like a weird thing to include if LipoLive actually worked. Finally, it turns out that that Chinese company has a difficult time getting those pure ingredients and only makes them once every 6 months. So if you only get 1 or 3 bottles, you may run out and not be able to replenish your supply in a timely manner. Dr. Ania warned that failure to complete the 6 month regimen could cause you to have to start over, so you don't want to risk running out. Oprah said that the website was the only place to get LipoVive, and she was concerned that stock was running out quickly.

There were hints that the video was not really Oprah and Dr. Ania, I mean aside from the ludicrous notion that pink salt and a few other ingredients could mimic the GLP-1- based weight loss drugs. Whenever the video showed a wide-angle shot of both Oprah and Dr. Ania at the table, their lips were not synced to the audio. However, the close-up shots were quite convincing and a testament to the power of (I assume) deepfake technology.

How do I know it was a deepfake (aside from all the other red flags)? Because the actual conversation between Oprah and Dr. Ania on The Oprah Podcast is also available on Youtube. Their conversation has nothing to do with the pink salt trick, and I recommend it for anyone interested in obesity. The genius of this whole thing is that it uses actual content from the podcast and intermixes it with fake material. The result is an informercial that slickly leverages the authority of Oprah and Dr. Ania to hawk LipoVive (...maybe?).

But Wait, There's More!
As it turns out, LipoVive has its own independent website. The LipoVive website seems legitimate (to the extent that these types of supplements can be called legitimate) and includes the standard disclaimer that "the FDA hasn't evaluated the statements provided on this page." While it claims that the product encourages (whatever that means) the natural production of the GLP-1 and GIP hormones [1], and that it assists in weight loss, it does not make any of the outlandish claims that the pink salt videos do. Also, instead of the 4 ingredients listed by "Dr. Ania", the LipoVive website lists 8 ingredients (none of which are pink salt, if you can believe it). This has me wondering if the pink salt trick website is a double scam: convincing people to buy a product that not only doesn't do what they hope it will do, but also isn't even real LipoVive. (Maybe they just take your money and run.) After all, the fake Oprah podcast is clearly grounds for a lawsuit, and presumably regulatory/legal action. If you were the maker of LipoLive, why would you endanger your business like that?

Through all of this, I feel like I may only be scratching the surface of the scam. I found other Youtube videos on the pink salt trick that led to a different website pushing a different product called Mitolyn, with no mention of pink salt. Other videos give a recipe that consists of pink salt, lemon juice, and honey. And with all of the different videos, I'm starting to wonder if the products are mostly beside the point and that most of the money is being made from video views. The cleverness of scammers shouldn't be underestimated.

Entertaining as this all is, the bottom line is that pink salt will not do anything meaninful to help with weight loss. Heck, it's not even in the products that are marketed at the end of the rabbit hole. And as the science of weight loss and obesity continues to progress and pharmaceutical companies develop drugs that acheive near-miraculous results, there will continue to be scammers that prey upon people by pushing ideas and products with no value.

Notes:
1. The GLP-1 and GIP hormones produced by the body are degraded very rapidly, so boosting their production isn't much help. The success of the drug versions is mainly due to the fact that they are modified to stay in the body for much longer.

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Would You Buy A Product That Tells You It Doesn't Work? Of Course You Would!

Whenever I go to a drug store, I feel a renewed sense of amazement. Consider the following two propositions:

1. You go to a drug store because you either have a health problem, or you want to prevent a health problem. (For our purposes, we're ignoring convenience needs like greeting cards, beauty products, food, etc.)

2. You want to buy a product that will fix or prevent your problem.

Those seem like reasonable assumptions to me. And yet, many of the products say right on the label, "This product is not intended to diagnose, treat, cure, or prevent any disease."

But wait, I thought you wanted something that treats, cures, or prevents a disease. Then why would you buy something that tells you it doesn't?

And it's not like it's just you. The sheer number of them testifies that lots of people buy them! Anecdotal experience bears this out, like when it's flu season and your neighbor says it's time to start taking a product that you know says it's not intended to prevent disease. I guess people just want to feel like they are doing something--anything--and are willing to pay for it.

We humans are weird.

By the way, I just want to let you know that I'll be starting up a new retirement investment fund. It's not intended to provide you any retirement income, but it will make you feel like you are preparing for retirement. I look forward to your business.

Notes:

For more, see FDA 101: Dietary Supplements

See also my previous post with a literally true title, There is More Regulation of Your Dog's Medicine than Your Dietary Supplements

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Ben Carson and the Fallacy of the Providential Diet

If you paid any attention to last week's Republican primary debate and the subsequent commentary, you'll know that there was some controversy over Dr. Ben Carson's answer to a question about his involvement with a dietary supplement company. From the transcript:

CARL: This is a company called Mannatech, a maker of nutritional supplements with which you had a ten-year relationship. They offered claims that they could cure autism, cancer. They paid $7 million to settle a deceptive marketing lawsuit in Texas, and yet your involvement continued. Why?

CARSON: Well, that's easy to answer. I didn't have an involvement with them. That's total propaganda. And this is what happens in our society. Total propaganda. I did a couple of speeches for them. I did speeches for other people. They were paid speeches. It is absolutely absurd to say that I had any kind of relationship with them.

Do I take the product? Yes, I think it's a good product.

CARL: To be fair, you were on the home page of their website with the logo over your shoulder.

CARSON: If somebody put me on their home page, they did it without my permission.

What Carson called 'total propaganda' turned out to be total truth, leading a writer at the conservative National Review to call Carson's answer "bald-faced lies." Further documentation of Carson's history with the company can be found here and here.

My interest here is in two statements he previously made about the product, separated by about 9 years.

The wonderful thing about a company like Mannatech is that they recognize that when God made us, He gave us the right fuel.
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God gave us [in plants] what we need to remain healthy. In today’s world our food chain is depleted of nutrients and our environment has helped destroy what God gave us.

Underlying much of advocacy for alternative health, anti-GMO, and anti-vaccination is the fallacious belief that 'natural' is better. Taking extracts of various plants is better than taking a drug, natural so-called organic foods are better than those that have been altered by genetic technology, and having an infectious disease somehow gives better immunity than a vaccine. Scientifically this is all baloney, at least in the broad strokes, but it sure has marketing appeal.

Carson's statements could be classified as a theological subset of the fallacious appeal to nature. I don't know whether he actually believes what he said, or whether this is religious rhetoric in the service of sales. It is certainly true that many useful drugs are derived from naturally occurring substances, but that doesn't seem to be Carson's point. Taken at face value, he seems to believe that edible plants in the natural world (created by God) contain the solutions to our health problems. Except, I guess, for the ones we already use.

This seems like a rather presentist belief to hold, by which I mean you have to ignore most of human history, during which life expectancy was pretty low compared to today. Many of our foods are the end products of artificial selection, and increased understanding and technology have allowed us to fortify common food items with a variety of dietary necessities (iodine in salt, vitamin D in milk, folic acid in flour, etc). As a result, dietary diseases like scurvy and rickets are practically unheard of in developed countries. To claim that our food is depleted of nutrients seems exactly backwards, except in the sense that many people choose to eat unhealthy foods.

In Carson's case, prostate cancer supposedly sparked his interest in Mannatech. I say supposedly because Carson has claimed that Mannatech's product alleviated his cancer symptoms. However, the documented timeline suggests that Carson had already had his prostate removed by the time he found Mannatech. At any rate, the notion of adding some exotic supplement to your diet as a way to prevent or treat cancer is the way of snake oil. Wrapping snake oil in praise for the providence of God still leaves you with snake oil.

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There is More Regulation of Your Dog's Medicine than Your Dietary Supplements

Did you know that in the U.S. drugs for animals are regulated by the Food and Drug Administration (FDA), which means that they must be shown to be safe and effective, and are manufactured under tightly controlled conditions?

Did you know that dietary supplements for people generally receive little-to-no scrutiny by FDA?

Last week's Science had a nice story of one physician's David-and-Goliath fight against tainted supplements. It all began when Dr. Pieter Cohen noticed that patients taking the same weight loss supplement started getting sick. This started him on a quest of testing various supplements for extra substances (chemicals, hormones, etc) and his work is getting the FDA's attention.

To understand the regulatory issue, you need some background. The dietary supplement industry is practically a libertarian's dream:

THE MODERN SUPPLEMENT ERA began in 1994, when Congress passed the Dietary Supplement and Health Education Act, or DSHEA (pronounced duh-shay-uh). In the decades before, the supplements industry was overwhelmingly focused on vitamins and minerals. Much of the regulation centered on recommended daily allowances of products like vitamin C, iron, or calcium.

DSHEA established the first broad framework for regulating supplements. It also gave supplements a legal definition: as substances intended to “supplement the diet,” containing “dietary ingredients” such as herbs, botanicals, or vitamins.

At the same time, the law sharply curtailed FDA's power. Companies were not required to notify FDA provided the dietary ingredient had a history of use before the law was passed. For the first time, DSHEA allowed them to make claims on the label suggesting supplements affected the structure or function of the body—for example, by boosting the immune system or protecting prostate health. And DSHEA codified a loose arrangement: Under the law, as FDA notes on its website, “unlike drug products that must be proven safe and effective for their intended use before marketing, there are no provisions in the law for FDA to ‘approve’ dietary supplements … before they reach the consumer.” The agency can act only after a supplement is on the market and evidence shows it's unsafe.

The article is accompanied by a graphic that says that "prescription and illegal drugs are routinely found in supplements." It has two examples of supplements that are supposed to help with sexual enhancement. Any guesses what was found in them? Answer: Viagra. The article gave me a little more sympathy for athletes who claim that they didn't know their supplements contained a banned substance. They really may not have known!

FDA has a Q&A page about supplements. It's worth reading through the whole thing, but check out this gem:

Do manufacturers or distributors of dietary supplements have to tell FDA or consumers what evidence they have about their product's safety or what evidence they have to back up the claims they are making for them?

No, except for rules described above that govern "new dietary ingredients," there is no provision under any law or regulation that FDA enforces that requires a firm to disclose to FDA or consumers the information they have about the safety or purported benefits of their dietary supplement products. Likewise, there is no prohibition against them making this information available either to FDA or to their customers. It is up to each firm to set its own policy on disclosure of such information.

The next time you are in the pharmacy, have a look at all of the products with the disclaimer that their claims have not been evaluated by the FDA.

I'm going out on a limb here, but my sense is that straight-up vitamins and similar products are not the main problem (though they may indeed be a waste of money [1]). Rather, in my opinion products that are claimed to actually help some kind of performance (strength, sexual, weight loss, etc) are more likely to have some kind of drug or hormone to help produce the desired effect, or the illusion thereof. Most people who take a multivitamin or similar product are not going to notice any substantial difference in their health, nor will they care. But when it comes to, say, weight loss supplements, consumers will expect to see some progress. The balance of incentives and disincentives to play fast and loose with the truth and your safety are quite tilted toward the manufacturer.

The irony of course is that many consumers of dietary supplements are operating under the illusion that they are avoiding 'unnatural' substances, or that the law wouldn't let manufacturers put claims on the bottle that are not true. In reality, most consumers don't really know what they are consuming, and don't realize how little evidence manufacturers need behind their products.

You have been warned.


Notes:
1. Most people get all the nutrients they need from their diet. However, I fully accept that some dietary supplements may be helpful for some people.

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Should Tea Be Allowed in Africa?

The history of Word of Wisdom observance in the Church is more interesting than you might expect. Many members are not aware that the uniformity of observance that is one of our most distinctive practices is a twentieth-century development that occurred primarily during the Joseph F. Smith and Heber J. Grant administrations. The story of this development is told in Thomas Alexander's classic treatment, "The Word of Wisdom: From Principle to Requirement [PDF]." However, the idea that the Word of Wisdom was not viewed as important before then goes too far in the other direction, according Paul Hoskisson's article last year in the Journal of Mormon History, "The Word of Wisdom in Its First Decade" [paywall]. Nevertheless, the strictness of observance did fluctuate within Joseph Smith's lifetime.

As part of his discussion, Hoskisson carves out two main exceptions to the Word of Wisdom: sacrament and medicine. When wine was used as part of the sacrament, it was obviously not viewed as a violation of Word of Wisdom observance. Similarly, medical exceptions were also tolerated, though not specifically recognized in D&C 89.

Even as late as the 1950s and early 1960s, I can remember faithful Latter-day Saints speaking of the medicinal use of tea and coffee. I have also heard anecdotal reports that some members continued to excuse their use of alcohol for medicinal purposes well into the second half of the twentieth century. Certainly statements about the medicinal value of prohibited substances reflect the generally held beliefs of members in Kirtland, Missouri, and Illinois.

Today in the Church the medical justification for breaking the Word of Wisdom has been severely restricted. I have not yet determined just when the medicinal loophole was tightened. Neither am I aware of any official Church prohibition today against legitimate medicines that contain the same active ingredients that are found in coffee, tea, and alcohol....

In short, from the date the Word of Wisdom was received in 1833, until at least the end of the nineteenth century, the Church seems to have implicitly or explicitly recognized two exceptions to strict abstinence—sacramental and medicinal—both of which were eventually eliminated or severely restricted.

(Fun Church history fact: A later example of the medical exception was when James E. Talmage temporarily took up cigar smoking, by order of the First Presidency.)

With this as background, I was interested to read an article on Slate.com a few days ago about wormwood tea as an anti-malarial. Medical authorities are worried that its widespread use could cause more harm than good by generating resistance to a class of anti-malarial drugs, but from a consumer point of view it's a no-brainer because it's cheap and easy.

The fact is that most traditional herbal remedies are probably useless, potentially dangerous, and will only delay a person’s efforts to seek proper medical treatment. But some herbs do have medically active compounds, albeit with varying levels of efficacy, and Africans are choosing to go that route because they know that drug supply won’t be cut off by war or corruption or bureaucratic incompetence. Herbs are not always going to be the right strategy, but the data about these unconventional interventions should be shared and discussed.

Let's put aside the question of what the best public health policy is. Would wormwood tea be prohibited by the Word of Wisdom? I'm not any kind of tea expert, but Wikipedia tells me that regular tea comes from Camellia sinensis, while wormwood is entirely different: Artemisia absinthium. So maybe on that basis it would not be considered prohibited. On the other hand, there's that T word. Maybe someone with more international Church experience than me would know.

Whatever the case, this seems like a worthy exception to the Word of Wisdom. The Word of Wisdom was made for man, not vice versa.

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Awesome Honesty (About Dishonesty)

This xkcd is good, but the quote when you arrow over the comic is priceless. Regarding CVS pharmacy stocking homeopathic remedies:

Telling someone who trusts you that you're giving them medicine, when you know you're not, because you want their money, isn't just lying--it's like an example you'd make up if you had to illustrate for a child why lying is wrong.

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Alternative Medicine Fails; Not That It Matters

I'm back from vacation, and although I'm not exactly awash in free time, I hope to push out some of the blog material that has been accumulating. First up: alt med.

A June AP news story looked at what has been gained by the government's spending of $2.5 billion on research into alternative medicine, much of it through the National Center for Complementary and Alternative Medicine (NCCAM). The answer: almost nothing. But let's back up.

NCCAM, and its earlier incarnation, the Office of Alternative Medicine, has been the personal project of Senator Tom Harkin (D-IA), who became convinced that bee pollen helped his allergies and that another Congressman had been cured of cancer by alternative medicine.

Last February in a Senate hearing, Harkin complained--I am not making this up--that NCCAM was too negative in that it was casting doubt on many treatments but not validating enough of them.

One of the purposes when we drafted that legislation in 1992 . . . was to investigate and validate alternative approaches. Quite frankly, I must say it's fallen short. I think quite frankly that in this center, and previously in the office before it, most of its focus has been on disproving things, rather than seeking out and proving things.

As if the problem is science!

There is a hierarchy of plausibility in alternative medicine. Toward the top are herbal treatments because they are basically unregulated drugs. It is entirely possible that some of them could be useful. Toward the bottom are homeopathy or treatments that claim to alter some sort of vital energy or life force, because they are essentially supernatural claims and are often rooted in pre-scientific notions about physiology and medicine.

I agree with those who argue that the term 'alternative medicine' is really a misnomer. To begin with, some things that are called alternative medicine are encompassed within mainstream medicine (e.g. nutrition, exercise, relaxation, and other healthy lifestyle activities). But beyond that, treatments that are shown to be effective are incorporated into mainstream medicine; those that remain untested or unproven are not, and don't really deserve to be called 'medicine'. I know which group I want when I get sick.

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